Sphenopalatine foramen: endoscopic approach with bony landmarks

• Published in: Journal of laryngology and otology 2015-07, Vol.129 (S3), p.S47-S52
• Main Authors: Nalavenkata, S, Meller, C, Novakovic, D, Forer, M, Patel, N P
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anatomic Landmarks - diagnostic imaging; Anatomic Landmarks - surgery; Arteries - anatomy & histology; Cadavers; Child; Dissection; Endoscopy; Endoscopy - methods; Female; Humans; Main Articles; Male; Middle Aged; Nasal Bone - anatomy & histology; Nasal Bone - diagnostic imaging; Nasal Bone - surgery; Nasal Mucosa - blood supply; Otolaryngology; Paranasal Sinuses - anatomy & histology; Paranasal Sinuses - diagnostic imaging; Prospective Studies; Pterygopalatine Fossa - anatomy & histology; Pterygopalatine Fossa - blood supply; Pterygopalatine Fossa - surgery; Surgeons; Tomography, Spiral Computed - methods; Tomography, X-Ray Computed - methods; Turbinates - anatomy & histology; Turbinates - diagnostic imaging; Veins & arteries
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215115000766

To establish whether nasal bony landmarks on computed tomography could be utilised reliably in endoscopic approaches to the sphenopalatine foramen. A prospective analysis of 102 consecutive helical computed tomography scans of the paranasal sinuses was carried out by 2 senior ENT surgeons. Distances from the sphenopalatine foramen to endoscopically palpable bony landmarks were measured. There were a total of 102 patients (45 females and 57 males), with a mean age of 62 years. The mean distance from the posterior fontanelle to the sphenopalatine foramen was 14.1 mm (standard deviation = 2.13). The average vertical distance of the sphenopalatine foramen opening from the bony attachment of the inferior turbinate was 14.13 mm. There were no statistically significant differences between any of these measurements (foramen width p-value = 0.714, distance from fontanelle p-value = 0.43 and distance from inferior turbinate p-value = 0.48). Determination of reliable bony landmarks is clinically useful in endoscopic surgery and can aid identification of the sphenopalatine foramen. The inferior turbinate concha and posterior fontanelle may be used as reliable computed tomography landmarks for endoscopic approaches to the sphenopalatine foramen.